Journal ArticleDOI
The Efficacy of Tranexamic Acid Versus Placebo in Decreasing Blood Loss in Pediatric Patients Undergoing Repeat Cardiac Surgery
Robert W. Reid,A. Andrew Zimmerman,Peter C. Laussen,John E. Mayer,Jed B. Gorlin,Frederick A. Burrows +5 more
TLDR
Tranexamic acid can reduce perioperative blood loss in children undergoing repeat cardiac surgery and the total transfusion requirements, total donor unit exposure, and financial cost of blood components were less in the tranexamic Acid group.Abstract:
The antifibrinolytic drug, tranexamic acid, decreases blood loss in adult patients undergoing cardiac surgery. However, its efficacy has not been extensively studied in children. Using a prospective, randomized, double-blind study design, we examined 41 children undergoing repeat sternotomy for repair of congenital heart defects. After induction of anesthesia and prior to skin incision, patients received either tranexamic acid (100 mg/kg, followed by 10 mg.kg-1.h-1) or saline placebo. At the onset of cardiopulmonary bypass, a second bolus of tranexamic acid (100 mg/kg) or placebo was administered. Total blood loss and transfusion requirements during the period from protamine administration until 24 h after admission to the intensive care unit were recorded. Children who were treated with tranexamic acid had 24% less total blood loss (26 +/- 7 vs 34 +/- 17 mL/kg) compared with children who received placebo (univariate analysis P = 0.03 and multivariate analysis P < 0.01). Additionally, the total transfusion requirements, total donor unit exposure, and financial cost of blood components were less in the tranexamic acid group. In conclusion, tranexamic acid can reduce perioperative blood loss in children undergoing repeat cardiac surgery.read more
Citations
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Journal ArticleDOI
The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients
Maria Rosa Costanzo,Anne I. Dipchand,Randall C. Starling,Allen S. Anderson,Michael Chan,Shashank Desai,Savitri Fedson,Patrick W. Fisher,Gonzalo Gonzales-Stawinski,Luigi Martinelli,David C. McGiffin,Jon Smith,David O. Taylor,Bruno Meiser,Steven A. Webber,David A. Baran,Michael P. Carboni,Thomas J. Dengler,David L. Feldman,Maria Frigerio,Abdallah G. Kfoury,Daniel Kim,Jon A. Kobashigawa,Michael A. Shullo,Josef Stehlik,Jeffrey J. Teuteberg,Patricia A. Uber,Andreas Zuckermann,Sharon A. Hunt,Michael Burch,Geetha Bhat,Charles E. Canter,Richard E. Chinnock,Marisa G. Crespo-Leiro,Reynolds M. Delgado,Fabienne Dobbels,Kathleen L. Grady,W. Kao,Jaqueline Lamour,Gareth Parry,Jignesh Patel,Daniela Pini,Jeffrey A. Towbin,Gene Wolfel,Diego H. Delgado,Howard J. Eisen,Lee R. Goldberg,Jeff Hosenpud,Maryl R. Johnson,Anne Keogh,Clive Lewis,John B. O'Connell,Joseph G. Rogers,Heather J. Ross,Stuart D. Russell,Johan Vanhaecke,Amanda W. Rowe +56 more
TL;DR: Institutional Affiliations Chair Costanzo MR: Midwest Heart Foundation, Lombard Illinois, USA Task Force 1 Dipchand A: Hospital for Sick Children, Toronto Ontario, Canada; Starling R: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Starlings R: University of Chicago, Chicago, Illinois,USA; Chan M: university of Alberta, Edmonton, Alberta, Canada ; Desai S: Inova Fairfax Hospital, Fairfax, Virginia, USA.
Journal ArticleDOI
Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis
TL;DR: Cumulative meta-analysis showed that reliable evidence that tranexamic acid reduces the need for transfusion has been available for over 10 years and surgical patients should be made aware of this evidence so that they can make an informed choice.
Journal ArticleDOI
Tranexamic Acid Reduces Intraoperative Blood Loss in Pediatric Patients Undergoing Scoliosis Surgery
Navil F. Sethna,David Zurakowski,Robert M. Brustowicz,Julianne Bacsik,Lorna J. Sullivan,Frederic Shapiro +5 more
TL;DR: Intraoperative administration of tranexamic acid significantly reduces blood loss during spinal surgery in children with scoliosis, a multivariate predictor of blood loss.
Journal ArticleDOI
Efficacy of tranexamic acid in pediatric craniosynostosis surgery: a double-blind, placebo-controlled trial.
Susan M. Goobie,Petra M. Meier,Luis M. Pereira,Francis X. McGowan,Randy Prescilla,Laurie A. Scharp,Gary F. Rogers,Mark R. Proctor,John G. Meara,Sulpicio G. Soriano,David Zurakowski,Navil F. Sethna +11 more
TL;DR: TXA is effective in reducing perioperative blood loss and transfusion requirement in children undergoing craniosynostosis reconstruction surgery.
Journal ArticleDOI
Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease A Scientific Statement From the American Heart Association
Therese M. Giglia,M. Patricia Massicotte,James S. Tweddell,Robyn J. Barst,Mary E. Bauman,Christopher C. Erickson,Timothy F. Feltes,Elyse Foster,Kathleen Hinoki,Rebecca Ichord,Jacqueline Kreutzer,Brian W. McCrindle,Jane W. Newburger,Sarah Tabbutt,Jane L. Todd,Catherine L. Webb +15 more
TL;DR: Thrombosis has long been recognized as a potentially life-threatening complication in children with congenital heart disease (CHD), children with acquired heart disease, and in adults with CHD.
References
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Journal ArticleDOI
The Risk of Transfusion-Transmitted Viral Infections
TL;DR: The risk of transmitting the human immunodeficiency virus (HIV), the human T-cell lymphotropic virus (HTLV), the hepatitis C virus (HCV), and the hepatitis B virus (HBV) from screened blood units donated during the window period following a recent, undetected infection is estimated.
Journal ArticleDOI
Reports of 355 transfusion-associated deaths: 1976 through 1985
TL;DR: Management systems for transfusion facilities should be created or revised to include the specific identification of personnel eligible to administer transfusions to provide written guidance and appropriate training, and to implement measures that target safe transfusion practices.
Journal ArticleDOI
Comparison of the hemostatic effects of fresh whole blood, stored whole blood, and components after open heart surgery in children
Catherine S. Manno,Kathleen W. Hedberg,Haewon C. Kim,Greta R. Bunin,Susan C. Nicolson,David R. Jobes,Elias Schwartz,William I. Norwood +7 more
TL;DR: It is concluded that the transfusions of less than 48 hours old whole blood is associated with significantly less post-op blood loss than the transfusion of packed red blood cells, FFP, and platelets in children under 2 years old who underwent complex cardiac surgery.
Journal ArticleDOI
Prophylactic tranexamic acid decreases bleeding after cardiac operations.
Jan C. Horrow,J. Hlavacek,Michael D. Strong,W. Collier,Isadore Brodsky,S.M. Goldman,I.P. Goel +6 more
TL;DR: It is concluded that prophylactic tranexamic acid can be administered safely to inhibit fibrinolysis during cardiac operations, decrease postoperative bleeding, and possibly decrease the frequency of blood product transfusion.
Journal ArticleDOI
Hemostatic effects of tranexamic acid and desmopressin during cardiac surgery.
TL;DR: Desmopressin exerts no hemostatic effect, with or without prior administration of antifibrinolytic drug, and tranexamic acid alone appears economical and safe in decreasing blood loss and transfusion requirement after cardiac surgery.
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Drugs to minimize perioperative blood loss in cardiac surgery : Meta-analyses using perioperative blood transfusion as the outcome
Andreas Laupacis,Dean Fergusson +1 more